TRACY CROCKETT (NPI# 1568011807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568011807 |
| Entity Type | Individual |
| Full Name | TRACY CROCKETT |
| Practice Address |
36408 Cognac St Winchester CA 92596-9108 |
| Practice Telephone | 9519266750 |
| Mailing Telephone | 9519266750 |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-09-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747A0650X |
Technician Specialization: Attendant Care Provider |
Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184626996 | Tracy Crockett | Physician Assistant | 2470 Daniels Bridge Rd, Bldg 200 Suite 251, Athens, GA 30606-6187 | 2005-08-11 |
| Street Address |
36408 COGNAC ST |
| City | WINCHESTER |
| State | CA |
| Zip Code | 92596-9108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881979276 | A Step In The Right Direction LLC | Community/Behavioral Health | 31123 Janelle Ln, Street Address, Winchester, CA 92596 | 2011-10-17 |
| 1316047624 | Garfield Beach Cvs LLC | Pharmacy | 30736 Benton Rd, Winchester, CA 92596 | 2006-09-25 |
| 1093785685 | Jose Garcia Jimenez | Dental Hygienist | 31835 Corte San Pablo, Winchester, CA 92596 | 2006-01-25 |
| 1134597321 | Maila Sucaldito Bundalian | Registered Nurse | 32864 Bachelor Peak Street, Winchester, CA 92596-5201 | 2015-09-04 |
| 1144213091 | Sharon Denise Clay Matemavi | Nurse Practitioner | 34875 Pourroy Rd Apt 1408, Winchester, CA 92596-8184 | 2005-08-25 |
| 1194045823 | Maria Celeste Solomon | Speech-Language Pathologist | 35081 Lone Hill Ct, Winchester, CA 92596-8344 | 2010-06-04 |
| 1790115814 | Angie Miller | Speech-Language Pathologist | 31160 Pinon Pine Cir, Winchester, CA 92596-8353 | 2013-11-26 |
| 1316556350 | Honestlove Global Homecare Agency LLC | In Home Supportive Care | 35676 Small Pine Ct, Winchester, CA 92596-8376 | 2020-07-27 |
| 1194351023 | Supannee Sandra Lertpaichaiyon | Pharmacist | 32627 Presidio Hills Ln, Winchester, CA 92596-8434 | 2020-03-23 |
| 1720376171 | Ildiko Venczel | Pharmacist | 30712 Benton Rd, Winchester, CA 92596-8466 | 2011-07-19 |
| Find all providers in zip 92596 | ||||
| Taxonomy Code | 3747A0650X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Attendant Care Provider |
| An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952942005 | Cammie Martin | Technician | 15 Upper St, Winchester, KY 40391-1341 | 2019-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700487691 | Hine Maumalanga | Technician | 1094 Folsom Ave, Hayward, CA 94544-5704 | 2020-11-05 |
| 1649871765 | Charles Leroy Appleberry II | Technician | 1100 S Chester Ave, Compton, CA 90221-4312 | 2020-11-04 |
| 1902407174 | Ryan Allen Merrell | Technician | 313 E. 17th Pl #l Costa Mesa, Costa Mesa, CA 92627 | 2020-11-04 |
| 1083212476 | Christina Elisabeth Brunn | Technician | 2818 Huxley Pl, Fremont, CA 94555-1416 | 2020-10-16 |
| 1790392165 | Amanda Moore | Technician | 6445 Village Center Dr, Building 7 Apt 101, Sacramento, CA 95823 | 2020-09-29 |
| 1730795543 | Corina Rochelle Burch | Technician | 3706 Calavo Dr, Spring Valley, CA 91977-1903 | 2020-09-17 |
| 1033724729 | Cinta Latrece Moore | Technician | 12329 Creekview Dr Unit 37, San Diego, CA 92128-6624 | 2020-09-10 |
| 1598379398 | Trina Diane Brown | Technician | 115 W Zane St, Long Beach, CA 90805-6327 | 2020-08-31 |
| 1437760766 | Jeri Lyn Allen-smith | Technician | 9228 Allano Way, Santee, CA 92071-2202 | 2020-08-11 |
| 1750991667 | Natalie Mari Norman | Technician | 5013 Englewood Dr, San Jose, CA 95129-4232 | 2020-08-05 |
| Find all providers with the same taxonomy | ||||
| City | WINCHESTER |
| Zip Code | 92596 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.